September 6, 2020 Legislative Update

 The inner dynamics of a legislative body is fascinating, and I get a window into it by being a committee vice-chair and a member of the House Rules Committee. It’s a window into, but not membership, in the power-brokering that occurs with the Speaker and committee chairs. For this special session to finish the budget work and further allocate federal relief funds (work that was too risky to do in June when so much was unknown), those two items remain the priority. However, if there is time before the budget is passed, each chair has been told that he or she can prioritize one other bill in their committee to try to get across the finish line.

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Health Care Priorities

My Health Care Committee chair and I have agreed that our priority is the passage of a health care workforce development bill that we had completed in February but that is being considered by the Senate. Assuming the Senate makes no changes to it so it doesn’t need to come back to us, the priority bill will become our hospital price transparency bill. The Senate is making changes to that one, so we will need to use our limited committee time to review that work and decide if we can agree in order to get it through.

Our health care work force was in crisis long before the pandemic, and we took testimony early in the session to dig deeper into it. We concluded that the most urgent gaps were in nursing at all levels and in primary care physicians, and that one opportunity would be through scholarship assistance for those two fields. We identified money towards these scholarships through accessing some that had been left partially unused from reserved funds from a court settlement.

Hospital price transparency is another really important issue. We got stakeholder consensus on a path forward to enable consumers to identify in advance what the actual costs to them would be for different procedures and among different hospitals. While many states have done similar things, the catch is that creating a user-friendly data base can be really expensive.

Our Senate counterparts like that bill, but want to add some new components – some things that are actually a new topic that would normally be a separate bill. So, if we want our bill to pass, we’ll need to take testimony from those affected in the small amount of remaining time. There are other bills we have received from the Senate, each of which would similarly require review time. The Senate says this new one is its priority, so it will be those others that are put off to be restarted next year.

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Mental Health Crises

Speaking of needing “to take testimony from those affected,” which I think is a critical part of our job, our committee was asked by the Speaker to taken on the review of another topic that came a bit out of the blue. The governor’s budget arrived in the House three weeks ago with a proposal to add seven positions for mental health workers “embedded” in state police barracks. It was in the Department of Public Safety budget, so under the division of labor among committees, it didn’t come to our health care committee for review.

There is pretty widespread consensus that we’ve been asking police to be all things to all people, which had contributed to some of the current need for policing reforms. “Jack of all trades, master of none.” We can expect abilities to de-escalate and stabilize crisis situations, but we can’t expect every officer to be a mental health counsellor or expert on top of the myriad other responsibilities we place upon them. We are really pleased that the governor recognized this as a sufficient priority to find funds in a tight budget to expand mental health support. (On Friday, the governor also announced a number of other policing reform initiatives the administration is implementing in advance of any pending legislation.)

A few weeks ago, an increase in funding for mental health outreach was selected as the most important priority for policing reform in a survey completed by 1,446 people in Vermont. In all, 62 percent of those responding said it was “extremely important,” the highest ranking of any of 10 suggested reform initiatives. More than one item could be selected in the survey. The next highest rankings were for increased training in de-escalation skills (54%) and requiring the use of body cameras (53%).

So, this is a critical initiative, but it also needs to be done right. Neither the Department of Public Service, in drafting the proposal, nor the Senate members who were pushing for it, actually talked with those who would be affected: neither with the clinical community, nor those who are part of the community of people who have experienced mental illness, like myself. Many years ago, when I was still dealing with significant symptoms, I was involved in two different situations where police were part of intervention. One was superbly handled; the other was significantly mishandled. So, I know this topic up front and personal.

We need the mental health-law enforcement collaboration, but there are many different models for how to achieve it. A core question: should this be a mental health system program that responds to assist police, or should it be a police department program that incorporates mental health staff as an arm of its own organizational structure? When the expansion proposal was discovered buried in the Public Safety budget there was some immediate concern about the model and why others weren’t involved in the planning. So, the Speaker intervened to ask our committee to rapidly dive in to take broad-based testimony and make a recommendation to the Appropriations Committee by the end of this coming week. The House budget will be finished this Tuesday, so there was “placeholder” language included to reserve the funding while our committee does its review.

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Health Disparities

The budget includes one specific proposal from our committee on further use of the remaining federal coronavirus relief funds. In the June allocations, we had asked for $1,000,000 to be put into special support for Vermonters who are members of “health disparity groups” who might need specific intervention – supports outside of what the general population needs. This included three groups where the particular concern was the higher risks from imposed social isolation: elders, people with disabilities, and LGBTQ youth. It also included groups with disproportionate rates of COVID-19 due to systemic health disparities: people of color and immigrant or migrant groups. The Health Department said they already had some emergency federal funds for that purpose, so our request was cut in half to $500,000.

Last week we heard what’s been done to date, and it was clear that although good work had happened, many of the groups we felt needed to be addressed had not received attention. We asked for an additional coronavirus relief fund appropriation of $1,000,000, including more explicit instructions about who to reach out to for identifying the specific needs, and the Appropriations Committee has added that to the budget.

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The Environment

One bill that moved forward last week will allow Efficiency Vermont some flexibility in the use of the money raised through our electric bill surcharges. This highly successful program (it is a 4-to-1 return on investment) was created to focus on reducing electricity use. This bill will allow EV to strategically use $2 million of its $60 million budget to address efficiencies in heating and transportation. It does raise or spend any new money, but allows an added range of use. Coming up this week, it is expected that the Senate changes to the Climate Solutions Act will be coming to the House floor for final approval.

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Cannabis

The marijuana tax-and-regulate bill was locked in a conference committee standoff between House and Senate, but each made major concessions last Friday afternoon. It appears that the final area of disagreement is solvable, so this bill is likely to move forward. The House has passed bills numerous times to make seat belt use a matter of “primary enforcement” (you can be pulled over for that alone; currently, there has to be another reason for the stop before you can get a seat belt ticket). Each time, the Senate has killed it. So, under the umbrella of the highway safety components of the marijuana bill, the House added seat belt enforcement. On Friday, the House agreed to drop that piece.

The saliva test in the House version (with the requirement of a warrant) has the purpose of screening drivers for drug use, similar to alcohol. The problem is that it isn’t remotely as accurate. It only detects presence of a substance, which could include marijuana legally used days ago. The Senate was adamantly opposed but has now agreed to it. The final big split was about whether towns have to hold a vote before a sales outlet can open in their community, or whether outlets are presumed to be permitted unless a town has a vote to prohibit. The Senate has now accepted the “opt-in” requirement.

That leaves only the disagreement over a tax structure component regarding how towns that permit sales outlets can share in financial benefits.

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Please feel free to contact Rep. Ken Goslant (kgoslant@leg.state.vt.us) or me (adonahue@leg.state.vt.us) at any time with your inquiries or input. It is an honor to serve you. You can see all of my past updates at representativeannedonahue.blogspot.com

August 22, 2020 Legislative Update

 Let me start this update with a PSA: please, if you haven’t yet, fill out your census information. You can save the hassle of someone coming to your door. More importantly, you can make sure you don’t get missed in the count. This stuff really matters! It matters for how much of a fair share we get of federal funding. It also matters for fair voting representation when Vermont does re-districting to align with town census numbers next year. It only takes a few minutes, and the questions are not invasive. Just go to my2020census.gov/

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The Month Ahead

People sometimes ask me in October how the legislative session is going. Just to be clear, Vermont has a part-time legislature which normally goes from January to early May. Of course, nothing is ordinary this year. We stretched into the end of June, nearly crippled by the constraints of functioning on Zoom and trying to do a rational job in allocating federal relief money, while at the same time holding off on the budget for the year ahead in order to have a firmer financial picture.

We are coming back into session now to pass the budget for the remaining ¾ of the fiscal year. There will be public hearings on the budget this Thursday, August 27, from 5 to 6 p.m. and Friday, August 28, from 1 to 2 p.m. via videoconferencing. For the link to sign up to testify and to see the budget information, go to legislature.vermont.gov/

Because of the overlap between this unique late session and early voting by absentee balloting, it will be the first time – to my knowledge, anyway – that we will actually be in session while voting has already begun. It will undoubtably inject new levels of political posturing into debate and votes. I will pledge to do my best to keep my updates as objective as possible so that they do not double as campaign messaging. It will be a strange campaign year for everyone, since going door-to-door, which I consider to be an obligation if one expects voters to put their trust in you, is off the table due to COVID precautions.

Our financial picture remains fuzzy, because we had hoped to know what to expect from the federal government in terms of further relief, and we do not. The revenue shortfalls are dire, but thankfully, not as dire as was feared back in May. Late tax returns from 2019, when the economy was still stable, brought in more than expected. While we are still more than $100m in the red, it now looks as though next year is when the greater impacts of the economic shutdown will be felt. The governor has proposed a budget that maintains services without raising taxes, but the devil is always in the details. Over the next few weeks, the House will analyze the proposal, counter with its own, and send it to the Senate. What is usually a four-month process will have only four weeks, since the budget needs to be signed before the end of September when the second quarter of the budget year begins.

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The Rest of the Agenda

There is some tension – both political, and reality-based – about what other business should be done in these next five weeks. Some argue that we should address only the budget and get out. We’ve already overspent the budget for the legislative session itself, and doing serious business by highly limited Zoom committee testimony and even more limited Zoom “debate” on the virtual House “floor” does not do justice to the issues or our constituents. On the other hand, a great deal of work was done on important issues back in January and February. Many finished the process in either the Senate or House, and now sit in the other body, awaiting action. Since we are at the end of a biennium, anything not passed now has to start from ground zero with a new legislature in January. If they can’t be fully vetted in the opposite body, it would defeat the checks and balances built into the bicameral legislative process to rush them through now. But if a few of them can, it wouldn’t be fair to bump them solely on the basis that we have to function in impaired ways.

Everything is impaired right now. We still have to make the best of it. So, while I oppose trying to pass legislation that can’t get a reasonable level of analysis (that’s what leads to bad law being passed), I also think that it isn’t reasonable to say that everything that had to be dropped in March has to be abandoned. I might not like some of those bills and wish that the disrupted process means they die, but that’s not a legitimate reason to not move forward.

What are some of the major bills on the list for consideration in September? The climate change bill (establishing a council that will have broad authority to set state standards); a bill on revamping our Act 250 development standards (which has had mixed reviews on its drawbacks and benefits); and the tax-and-regulate marijuana bill (which did pass both houses, and is now in the hands of a six-member conference committee to seek compromise between the different versions.)

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Police Reform

Another item on the agenda is police reform, tied into the larger issue of addressing systemic racism. Vermont is not immune in needing to address this. In response to some rapid-fire action by the Senate, we passed a bill in June that was very incomplete. It was consciously incomplete. It carried a multi-layered message from the House, along these lines: the Senate did not use a deliberate enough approach and we don’t have time to fix its work; we recognize the need to take some kind of action to show good faith; we are locking ourselves in to coming back and doing better work in August. It did that by including sunsets in the law: dates less than a year away by which parts of the new law will be revoked. So further action must be taken, or the effort comes to an end.

One of the pieces the House recognized was the importance of hearing the voices of Vermonters before making major changes. Over the past several weeks, there have been three public hearings and a broadly disseminated survey. A total of 1,446 responses came in from all over the state, a pretty phenomenal response. I feared that the survey might get limited or skewed exposure, but having skimmed the many comments that people added in their responses, it is clear that a broad range of perspectives were captured. There were some great insights shared. The full survey will be shared publicly in short order. I got a preliminary look because I am part of a coordinating group that was helping to organize the public outreach.

I’m sorry, however, to see some of the divisiveness that seems to exist right now across so many subjects also becoming entrenched in the policing issue. One Facebook meme articulates my perspective well. It has three circles that overlap in the center: one circle says, “Supports good police officers,” the second says, “Believes that black lives matter,” and the third, “Upset at police brutality.” In the center overlap it says, “Me,” and notes at the bottom, “Guess what? It’s okay to believe all three.” Recognizing that our police are overwhelmingly sincere and well-intentioned, doing a tough job and under a lot of pressure doesn’t mean not recognizing that there are areas of change that are needed, particularly in accountability and often in attitudes towards the public. It’s hard for anyone to maintain a positive and collaborative attitude when you see so much of the darker side of society, but it’s part of the job.

We also need to understand that just because not all of us feel intimidated or bullied does not mean it is not the valid experience of many, particularly members of minority groups. Those experiences matter. As a member of a disenfranchised minority group – people with a history of mental illness – I have shared that experience personally.

That extends to the broader issues of the criminal justice system, education, employment and all sectors of society. Slavery was legal in our country for almost 250 years; the era of widespread public lynching ended only in about 1950; brutality against civil rights leaders was within the lifetime of even more of us. It shouldn’t be a surprise that we still have much to overcome.

No one is being asked to apologize for being white, but rather to simply recognize that we have benefitted historically and still benefit from the systems that evolved as a result of slavery. Saying black lives matter isn’t saying white lives don’t. It is saying that our social systems still treat black lives as though they don’t matter as much, and that’s wrong. The focus should not be on being defensive. We should be thinking about what each of our personal roles should be in helping to build a more equitable society.

And yes, it impacts Vermont. The debate shouldn’t be whether or not we need this to be on our agenda as a state; it should be, instead, a healthy dialogue about what the best means are to move forward – which also means listening to our friends and neighbors who live with these impacts.

Vermont is offering us a good opportunity for starting that discussion in this year’s “Vermont Reads” program of Vermont Humanities, which is now in its 18^th year. The program invites people across the state to read the same book and participate in a wide variety of community activities related to the book’s themes. The Hate U Give by Angie Thomas was chosen last year as the book for 2020, and it was a prescient choice. This year the Brown Public Library and the Northfield Equity Awareness and Justice Group will be collaborating to host the Community Wide Vermont Reads Book Discussion as an outdoor, socially distanced event on Tuesday, September 29 at 6 pm. A limited number of copies of the book are available at the library by phone or email request.

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Please feel free to contact Rep. Ken Goslant (kgoslant@leg.state.vt.us) or me (adonahue@leg.state.vt.us) at any time with you inquiries or input. It is an honor to serve you. 

Legislative Update on Available COVID Grants

Interim Legislative Update: COVID Relief Funds

Rep. Anne Donahue

August 5, 2020

 

Hello folks,

This is an interim update about what is rolling out and available in COVID-19 relief funds that were passed by the legislature in June. We will be back in session on August 25 to begin the work on the budget for the remaining two thirds of the session.

Please remember the primary on August 11! Voting will still be available in person. If you have not sent an absentee ballot by mail yet, it is being recommended that you DO NOT rely on it getting there by mail in time to be counted. If you want to vote absentee, you can still turn the ballot it by hand to the town clerk’s office. For the general election on November 3, ballots will be mailed to everyone who is on the voter checklist. If you are not registered, you still need to do so. Polling places will still be open for those who prefer to vote in person.

 

Relief components of Vermont CARES appropriations

These range from not-yet-available to already in place with first-come-first-served and date cutoffs this month.

 

Overview of supports for individuals:

-                        Utility cutoff fund, $8 million, Public Service Department. Not yet in place because it applies after the moratorium on cutoffs ends, currently set for September 30.

-                        The Vermont State Housing Authority was provided with $25 million for rental arrearage to prevent evictions. Applications available now. www.vsha.org/rental-housing-stabilization-program/

-                        Department of Housing and Community Development was provided with $5 million to prevent foreclosures. Applications will be accepted until August 31 unless funds run out sooner. www.vhfa.org/map/

Indirect support to individuals.

-                        A program is being created with $5 million for restaurants to provide food to individuals. There is current an RFP for community organizations to apply to run the program; applications taken on a rolling basis and reviewed when received and continuing until funds are fully allocated. www.sevca.org/vt-everyone-eats Participating restaurants will be paid $10/meal; go to SEVCA website.

-                        The hazard pay grant program ($28 million) goes through employers. Applications are now open, first-come-first-served. Employees should reach out to their employer directly and refer them to program guidance located on the website. dvha.vermont.gov/front-line-employees-hazard-pay-grant-program. (Municipal employees are not eligible, but municipalities can receive grants for COVID expenses through the Agency of Administration, which can include providing hazard pay; $13 million appropriated. aoa.vermont.gov/)

-                        Landlords can receive grants of up to $30,000 to renovate and get blighted properties back on the rental market. ($6.2 million total) Department of Housing and Community Development; program not yet listed as underway.

 

Businesses overview

-                        Internet connectivity to underserved communities, $12 million. RFP process open is currently open for internet providers; the deadlines for proposals for the first two of three rounds are August 14 and August 21. publicservice.vermont.gov/content/connectivity-initiative-0

-                        The business grant program is now taking applications, $150 million, first-come, first-served; applications currently open. accd.vermont.gov/covid-19/economic-recovery-grants.

-                        Health care entities (including small/independent practices), $275 million, applications now open, deadline August 15. humanservices.vermont.gov/

 

Program details

Utilities

The Department of Public Service received $8 million to prevent disconnection; takes effect after the temporary moratorium ends; moratorium currently extends to September 30. (Program application process not yet listed, likely due to the delayed effective date.)

Statute:

Act 137. An act relating to COVID-19 funding and assistance for broadband connectivity, housing, and economic relief.

Sec. 20. DEPARTMENT OF PUBLIC SERVICE; UTILITY RATEPAYER ARREARAGES The sum of $8,000,000.00 is appropriated to the Department of Public Service for the purpose of simultaneously minimizing financial hardship caused by the COVID-19 public health emergency and also mitigating utility rate increases ultimately shared by all ratepayers, the Commissioner of Public Service shall develop policies and practices for providing financial support to utility ratepayers to cover account arrearages of ratepayers likely to face disconnection when the moratorium ends.

 

Housing

The Vermont State Housing Authority was provided with $25 million for rental arrearage. Information is at www.vsha.org/rental-housing-stabilization-program/

The Department of Housing and Community Development was provided with $5 million to prevent foreclosures. VHFA intends to prioritize applicants with lower incomes, but given the limited amount of funds and the limited time to review applications and distribute awards there is no assurance that any individual application will be funded. Applications will be accepted between July 13 and August 31 (this period may be shortened with little to no notice if application volume exceeds expectations). Information at www.vhfa.org/map/

The Department of Housing and Community Development was provided $6.2 million for grants to landlords to repair blighted property to get it back on the rental market. There are no announcements yet about this program.

Statute:

Sec. 11. COVID-19 RESPONSE; HOUSING

(3) Foreclosure protection. $5,000,000.00 to the Department of Housing

and Community Development for a grant to the Vermont Housing Finance

Agency to provide financial and technical assistance to stabilize low- and

moderate-income homeowners and prevent home foreclosures for Vermont

families.

(4) Rental assistance; eviction protection. $25,000,000.00 to the

Department of Housing and Community Development for a grant to the

Vermont State Housing Authority, which shall administer the distribution of

funds to landlords on behalf of tenants in need of rental arrearage assistance.

 (5) Rehousing investments.

(A) Creation of Program. The amount of $6,200,000.00 is appropriated to the Department

of Housing and Community Development to

design and implement a Re-housing Recovery Program to provide funding to

statewide and regional housing partner organizations for grants to eligible

applicants… (I) A property owner may apply for a grant of up to $30,000.00

per unit. (II) To be eligible, a unit must be blighted, vacant, or otherwise

not comply with applicable rental housing health and safety laws.

 

Food

An allocation of $5m is for a new program called Everyone Eats, which supports restaurants feeding Vermonters in need. Southeastern Vermont Community Action (SEVCA), the fiscal agent for the program, is requesting proposals from community organizations around the state to further these programs in the months ahead. Visit the SEVCA website for more information and to submit a proposal. Participating restaurants will be paid $10/meal and at least 10% of the ingredients for each meal must be sourced from local farms and value-added food producers. Interested restaurants should contact SEVCA. www.sevca.org/vt-everyone-eats

Statute: (3) $5,000,000.00 to the Agency of Commerce and Community

Development to grant to Southeastern Vermont Community Action to act as

fiscal agent for a statewide program, Restaurants and Farmers Feeding the

Hungry, the purpose of which is to provide assistance to Vermonters who are

food insecure due to the COVID-19 public health emergency by engaging

Vermont restaurants that have suffered economic harm due to the COVID-19

public health emergency to prepare meals using foodstuffs purchased from

Vermont farms and food producers… (B) Under the Program, SEVCA and partners shall:

(i) establish multiple community-scale hubs across Vermont to

coordinate restaurant engagement and distribution of not fewer than 15,000

meals per week…

 

Connectivity

“The Department of Public Service is issuing a new round of Connectivity Initiative funding along with the newly-created Get Vermonters Connected Now Initiative ("GVCNI"). This grant cycle will be funded by the Coronavirus Relief Fund, and is subject to its restrictions. H.966, which establishes the GVCNI, directs the Department to prioritize underserved locations with K-12 students, teleworkers, and those with identified telehealth needs. The Department will publish peridically-updated lists of eligible and priority addresses. Priority addresses are defined as: Locations lacking a connection faster than 4/1Mbps; Locations with a K-12 student lacking a 25/3 Mbps connection; Locations with a remote worker lacking a 25/3 Mbps connection; Locations with telehealth needs lacking a 25/3 Mbps connection.” The Department is making $12 million available for grants, which will be distributed in three funding rounds of $4 million each. The upcoming deadlines for proposal submission are August 14 and August 21. For more information, see publicservice.vermont.gov/content/connectivity-initiative-0

Statute: Sec. 13. COVID-RESPONSE ACCELERATED BROADBAND

 CONNECTIVITY PROGRAM

(a) The sum of $17,433,500.00 is appropriated to the COVID-Response

Accelerated Broadband Connectivity Program, a newly established program

administered by the Commissioner of Public Service, consistent with the

requirements of this section. The purpose of the Program is to rapidly and

significantly increase broadband connectivity consistent with the federal

parameters applicable to expenditures under the Coronavirus Relief Fund in a

manner that best serves the State’s goal of achieving universal 100 Mbps

symmetrical service by 2024 as specified in 30 V.S.A. § 202c. To achieve this

purpose, the Commissioner is given broad discretion to allocate funding, as he

or she deems appropriate, subject to legislative oversight as required under

subsection (m) of this section, to support the following programs and

initiatives: (multiple subparts)

 

Hazard Pay Grants

The Front-Line Employees Hazard Pay Grant Program is for certain public safety, public health, health care, and human services employers whose employees were engaged in activities substantially dedicated to mitigating or responding to the COVID-19 public health emergency during the eligible time period, March 13, 2020 through May 15, 2020. The Agency of Human Services (AHS) is administering this program. The application period is August 4 through October 31 or until grant funds are depleted, whichever is earlier. Only covered employers may apply for this grant opportunity on behalf of their employees, employees should reach out to their employer directly and refer them to program guidance located on the website. dvha.vermont.gov/front-line-employees-hazard-pay-grant-program

Statute: Act 136. An act relating to health care- and human services-related appropriations from the Coronavirus Relief Fund.

Sec. 6. FRONT-LINE EMPLOYEES HAZARD PAY GRANT PROGRAM

(a)(1) There is established in the Agency of Human Services the Front-Line

Employees Hazard Pay Grant Program to administer and award grants to

certain public safety, public health, health care, and human services employers

whose employees were engaged in activities substantially dedicated to

mitigating or responding to the COVID-19 public health emergency during the

eligible period.

(2) The sum of $28,000,000.00 is appropriated from the Coronavirus

Relief Fund to the Agency of Human Services in fiscal year 2021 for the

administration and payment of grants pursuant to the Front-Line Employees

Hazard Pay Grant Program established in subdivision (1) of this subsection.

 

Local government

Cities, towns, villages, and other government entities may apply for funding through the Agency of Administration, which will administer a special grant fund and issue grants to units of local government to reimburse eligible COVID-19 expenses incurred on or before December 30, 2020, including hazard pay, supplies and equipment, sanitation, facility alterations, overtime compensation, redirection of staff for first-response needs, and any other eligible COVID-19 expenses not covered by other funding sources, including funding provided by the Federal Emergency Management Agency. aoa.vermont.gov/

Statute: Act 136. Sec. 7. COVID-19 EXPENSE REIMBURSEMENT; LOCAL

 GOVERNMENT

(a) The amount of $13,000,000.00 is appropriated from the Coronavirus

Relief Fund to the Agency of Administration for the purpose of issuing grants

to units of local government to reimburse eligible COVID-19 expenses

incurred on or before December 30, 2020, including hazard pay, supplies and

equipment, sanitation, facility alterations, overtime compensation, redirection

of staff for first-response needs, and any other eligible COVID-19 expenses

not covered by other funding sources, including funding provided by the

Federal Emergency Management Agency.

 

Business grants

ACCD and the Department of Taxes are administering Economic Recovery Grants for certain business types. Other state agencies are also administering grants for other types of businesses. Applications are first-come, first-served until funds run out.  Grant guidelines and links for all business grants are available at accd.vermont.gov/covid-19/economic-recovery-grants

 

Health care grants

The Agency of Human Services is administering a $275 million Health Care Provider Stabilization Grant Program for a broad array of healthcare providers including: hospitals, private medical practices, dentists, health centers, laboratory and imaging centers, mental health providers, substance abuse disorder treatment providers, emergency medical service and ambulance providers, physical therapists, podiatrist, optometrists, chiropractors, and other health care providers licensed by the Board of Medical Practice or the Office of Professional Regulation. This also includes home health and hospice agencies, pharmacy services, and long-term care providers. Providers have until August 15 to submit applications for funding. Funding will be allocated based on need, to the extent that funds are available. humanservices.vermont.gov/

 

 

July 5, 2020 Legislative Summary

I’ve seen a lot of Facebook jokes about turning 2020 back in and asking for a new year, and I can certainly relate to that from the perspective of a summation of the legislative session. Perhaps it’s apt that this end-of-session summary comes in July instead of May – and comes when the session isn’t over yet, since we have to return in September.

I’m pretty new to Facebook. I’ve used it in the past pretty much just to share occasional pictures, but I jumped in with both feet in March to communicate updates on the pandemic to constituents. I have to give a big kudos to Front Porch Forum, which for three months suspended its monthly posting limit for public officials to likewise allow an expanded ability for information-sharing.

As a whole, I think the legislature fulfilled its duties well in the face of a crisis. In two days’ time in early March we passed sweeping legislation to empower the executive branch to take actions as needed to keep government (and in particular, health and human services) going. We then bumbled our way through Zoom goof-ups and struggled with a process that is dependent upon dialogue and face-to-face engagement that was forced to play out awkwardly over a computer screen instead. At the end of June, we passed a first quarter budget and allocated more than $800 million in federal relief funds to help form the base of a Vermont recovery.

I was not happy with all of the decisions, or the hectic process and lack of testimony or discussion, but as a whole, we pulled together as best as we were able to identify and meet priority needs. I think we needed to put more into economic recovery for our business community, which was devastated as a result of government directives to close down. Without their recovery, nothing much else will fall into place. But a major grant program is now underway, and represents a fair amount of what the governor recommended.

It represents a classic tension: are people helped most when the economy is restored, which argues for the investment going there, first? Or if the economy is in dire straits, does more need to be invested, first, in direct help to those without jobs or other supports? One of the largest investments that the legislature prioritized at a higher level than the Governor was housing and social service supports to get previously homeless folks into permanent, stable housing.

These included some long-term investments in housing stock, along with short-term rental subsidies. I was a bit nonplussed, however, when one member of the committee happily asserted that by getting everyone into a home, we may lick the problem of homelessness once and for all. That assumes that if every person who is currently homeless (and is temporarily in a motel) is able to become housed, there will never be new folks in crisis.

Some years ago, on the Human Services Committee, we delved deeply into the data on families receiving Reach Up support. Contrary to commonly-held assumptions, it showed that the overwhelming majority of families are only on the program for a year or two, using it as intended to get back on their feet. There will always be a small number who struggle more, as well as a few who abuse any system and give everyone a bad name, but they are a minority.

Homelessness, likewise, is not an issue for only a set group of people at a single point in time. We will need to continue to give folks a helping hand – because that is what a caring society does – but one big investment is not going to end the cycle. I don’t oppose the investments we made with the federal aid, but I think we may be overselling the long-term benefits. When it comes to tough choices, more investment in rebuilding jobs may do more to help keep families out of crisis than a one-time shot in the arm for housing.

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Items of Contention

While most of the big initiatives were achieved through compromise and consensus, there were partisan skirmishes. One was a debate over approving the state employee Pay Act now, as part of the first quarter budget, or waiting until September. We’re holding off on the full year budget because we know so little yet about what the economic impact is going to be from the pandemic and whether there is going to be more federal aid to states. From my perspective, locking in the Pay Act increases may force our hand in September for more layoffs, instead of being able to make educated judgements then. The Pay Act was voted in, however.

At the same time, we passed a change to existing law about how legislator salaries are increased. Currently, they are tied to the state employee COLA adjustment. Under the change, we will also add whatever we vote on annually for increases to statewide elected officers.

Supporters claimed we were not passing a pay raise for ourselves, because it has no impact this year (or in fact, in any year, unless we increase the pay rate for constitutional offices – which we happen to do, most years.) They also argued, in a bit of a contradiction, that increased pay was necessary to enable more people to be able to afford to run for office.

I think we do need to be looking at the issue of whether legislative pay allows for equitable opportunity. However, choosing to change the formula for automatic future increases at the very same time that we are freezing jobs and facing a huge budget deficit, and with thousands of Vermonters out of work and facing an uncertain future, is a slap in the face to our constituents.

I asked for the issue to be separated out from the Pay Act to vote on it as a specific item, and some Democrats joined in opposition, but the change in the formula passed nonetheless, 82-61.

***

Health Care

We set aside the largest piece of federal aid for stabilizing our health care system. We also extended many of the emergency provisions of executive authority to amend or suspend regulations. One question that raised: if all those regulations can be set aside, do we really need them all?

So here is a random example of what these waivers actually mean. Let’s say that under current rules, residential care homes are required to be inspected at least annually. I’m comfortable with saying that if the state needs all hands on deck to respond to a pandemic, we need to allow the discretion to waive some inspections until staff are available to do them. I’m not comfortable with saying that this demonstrates that we don’t need to require inspections at all.

The health system’s financial crisis raised an entire other set of questions. It was a dramatic illustration of some of what is wrong with the way it functions now. Doctors and hospitals are paid for each service. When services are suspended, there are no revenues. It’s just like when a restaurant isn’t serving meals any more.

Yet we expected that system to be fully functional and able to handle a potentially catastrophic level of COVID-19 illness. We have an expectation of a level of “serving the public good” that we need to be prepared to pay for. It makes a good argument for the health payment reform model that Vermont is experimenting with right now. If payers (the insurers) reimburse for overall care, rather than per service, it seems likely that we can run a better and more efficient system.

Because we have multiple payers (Medicare, Medicaid, and private), that means funneling them all through one entity that represents all of the participating providers. That’s why it is called an “all payer model.” In Vermont’s experiment, that entity is an accountable care organization called OneCare.

The state auditor came out with a report last week that critiqued the state’s oversight board for not doing enough to verify that OneCare is saving enough money to justify the cost of its oversight. That is, indeed, the multi-million dollar question, and has been my concern since day one. Will this new mega-bureaucracy pay its own way? The auditor is spot-on. We have to find better ways to analyze this before we extend the model.

But I did find one of the critiques amusing. The auditor noted that OneCare is a monopoly, which he said creates serious risks for both cost containment and quality. Ah, yes. Like, perhaps, a government-run system might be?

***

Looking Ahead

Although in theory we are returning in September only because we have to finish the budget for the remaining three-quarters of the year, once back in session, every bill that is partway through the process – through either the House or Senate – remains in play.

So depending on time, efficiency, and the will of the majority, some major issues abandoned in March could be back on the table, such as the climate change bill (which has awesome goals, but turns all authority over from the legislature to an appointed board) and the tax-and-regulate marijuana bill (which is currently at an impasse between House and Senate versions.)

The other ongoing issue will be addressing racial disparities and standards for police use of force. The Senate sent over two bills the week before we adjourned, and has a third on the way, related to policing.

The House, very wisely, put the brakes on the rush job. Doing something, just to show we did something in response to a national crisis, is not usually a wise course. Over an intense 3-day period, two House Committees looked at the Senate work and focused on a few narrow consensus points that could be addressed in the short term: state police body cameras, and a chokehold ban.

But as a whole, they listened to the stakeholders, who asked that they slow down and do it right.

There is an old saying that taxes cannot be both simple and fair. The process of legislation cannot be both expedited and inclusive. Inclusive is what matters in addressing systemic racism, because one of the reasons it continues to exist is that we do not listen to the very people who are most affected.

I learned the slogan, “nothing about out, without us,” from my disability community, but it applies broadly. Doing things “on behalf of” others without including their voices merely perpetuates the dismissal of those voices and thus the disenfranchisement that is at the very root of many of our deepest issues of inequity.

We have a long road to go, but have committed to going beyond just the first steps – the further work done in September will still just be the beginning.

***

Feel free to get in touch any time with Rep. Goslant and me. It is an honor to serve you. (kgoslant@leg.state.vt.us; adonahue@leg.state.vt.us) This and all of my previous legislative updates are available at representativeannedonahue.blogspot.com.

June 6, 2020 Legislative Update

Water, water everywhere, nor any drop to drink.

That line from Samuel Taylor Coleridge’s “The Rime of the Ancient Mariner” has come to mind repeatedly for me over the past several weeks as we face huge deficits in our budgets despite having that $1.25 billion in federal COVID-19 bailout money. We have received far more from the Coronavirus Relief Fund (CRF) per person than most states, because the “small states” formula places a minimum amount in fund distributions. But the money is tightly limited to use for expenses caused by COVID-19 and to be fully expended by December 30.

It very explicitly is not permitted to be used to make up for revenues we’ve lost, or to pay for anything that was already in our usual state spending. Best guesses at this point put our lost revenues for next year’s budget at $400 million. Making up for that could result in very severe cuts to state services of all types.

There is a hope that Congress might relent and allow some of the CRF money to go directly to the bottom line for state budgets. For that reason, the legislative leadership has made the decision to hold back on spending $400 million of our CRF funds for several months, so that in September when we build the budget for October-July, the cash will still be there if it turns out we can use it.

The Governor is proposing getting all the relief funds out the door as soon as possible, because both businesses and our health care system are in deep financial trouble and need it to keep the doors open. That means the big chunks of spending proposed by the Governor in contrast to what the legislature is considering differ significantly, even though many priorities are similar.

Of the $1.25 billion, $275 million has been spent or committed already for urgent needs. The administration has proposed relief packages of $400 million for economic stabilization to help small businesses get back on their feet and restore jobs. The governor’s second major package was proposed this week: about $330 million more for health care providers at all levels, from hospitals to independent practices to nursing homes to community mental health. That’s getting pretty close to the full amount, but the governor has not spelled out other proposals yet.

This week, the House Speaker listed out assignments for our committees, with one week to make our recommendations to our Appropriations Committee on how to use the money so that we can pass a bill and get it to the Senate. Her figures show a total of $575 million to be allocated in our “Phase 1” of rescue money after deducting the $275 million “already spent” and the $400 million in reserve.

My committee’s allocation for health care is roughly $175 million for health care, with another $100 million for “Phase 2,” if we learn by September that we still have not gained authority to use CRF money in the regular budget. We haven’t been told exactly what the other committees have been given to work with, other than that the economic development money is the other major bucket (in line with the governor’s priorities), and that Human Services, Energy and Technology, and Agriculture also have significant pieces of it for elements not included in the governor’s plans. These are for such areas as child care, housing and broadband development.

The biggest immediate impact of the different approaches between the governor and the legislature – that $400 million reserve amount – was evident this week when we voted on the first quarter state budget. This budget only covers from July through September so that we can have more certain numbers before creating the full budget. The governor, based on current best estimates, proposed cutting spending from last year by eight percent across the full year. That would amount to bigger cuts than that, because upward pressures such as the state employees negotiated salary increases will cut into it as well.

The House budget proposes level funding instead (which will still mean a hiring freeze), with a key argument that we shouldn’t begin making cuts when we still know so little about our financial picture and how quickly the economy might begin to rebound. What that means is that come September, if Congress doesn’t change current rules so we can’t use the reserved $400 million, and the economy doesn’t perk up more than currently estimated, that eight percent in cuts will have to be spread over nine months instead of 12. That level of cuts would be even more devastating to state services, with more layoffs and greater reductions in every part of government.

Although I believe it is right to hold back that $400 million “just in case” we can rescue our budget with it, I think that’s a long shot. I think it’s an even bigger long shot to think our revenues will do better than expected. So, I did not vote to support the first quarter level-funding budget. I was only one of five who did not go along with our Appropriation Committee recommended budget, which had been a unanimous proposal by the committee.

***

My committee has until Wednesday to propose how to spend the health care portion of the federal relief money. A coalition of providers has aligned with the administration’s proposal that it all go into one big bucket that the administration will dole out on needs-based criteria through a grant process.

In some ways, given the federal limits, it’s the only way to go. Whether it’s $175 million or $330 million, it still isn’t nearly enough to make up for the costs of gearing up for COVID and the amount of health care revenues lost. When your dentist’s office had to close, it had zero revenue, just like with any other business. However, as essential as our entire business community is, we particularly can’t let our health care providers go out of business or have hospitals close down.

My committee is looking at whether we can carve out small pieces of the money for direct aid to people who have lost income and can’t pay for a doctor’s visit and for some initiatives to begin to address health disparities. Our access to health care is inequitable and thus health outcomes worse, when it comes to minority populations: our Vermonters of color, migrants or immigrants, people with disabilities, and those in the LGBTQ community.

“Small pieces of money”: what a strange new world we are in, because for CRF money that might mean $5 million. In our typical budget, we debate over programs that cost less than $100,000, and we will be back at that when we start looking at cuts in September.

“Water, water everywhere, nor any drop to drink.”

***

A few pieces of other business go on. I presented our health care committee bill on the (virtual) floor last week. It was pared down from the 13 initiatives we had been working on prior to March to the five we considered most essential.

I’m particularly glad about one, because it’s the first step towards addressing a real thorn-in-the-side for doctors: the pre-authorizations required by insurers for certain tests or specialty referrals that add heavy administrative costs. The bill puts insurers to work at developing two changes: cutting out the requirements for services that are virtually always approved and cutting out requirements for doctors whose requests are virtually always approved.

Other main components in the bill included establishing a council to implement the recommendations in a 10-year vision plan for finally fully integrating mental health into a holistic (mind-body) health care system. The plan was developed after “listening sessions” across the state and intensive work by stakeholder who provide and receive mental health care. This council will be focused on bringing the rest of the health care system to the table to review how to achieve the goals.

Finally, the bill adds some quality oversight requirements for the Brattleboro Retreat. We have needed to bail it out financially, repeatedly (even pre-COVID) because it provides more than half the inpatient psychiatric care in the state. There was $7 million more in April and another $10 million coming in July. But there have also been repeated quality concerns. This is Vermonters’ money being spent; we want to protect the quality of care Vermonters receive there.

***

Please continue to stay in touch with me and with Rep. Ken Goslant. We’re both here to serve you, so contact us with questions or issues of concern. You can reach us anytime at adonahue@leg.state.vt.us or kgoslant@leg.state.vt.us.

May 23, 2020 Legislative Update

I stood on the House floor last week – correct that – I sat in front of my laptop on Zoom last week, and addressed my colleagues about the capital construction bill we were about to vote on.

“Last week, hundreds of my constituents from Berlin and Northfield waited in their cars in line for hours – not a couple of hours, but some for five, six hours – to get a box of food,” I told them. “How could I ever look them in the eye and say I voted for a bill today to spent $75,000 for new drapes and carpets in the statehouse?”

It was not a rhetorical question.

Every year we pass a capital bill, which authorizes bonding for major investments that are needed to keep our buildings safe and sound, and sometimes to replace them. This year’s bill was solid. It was well thought through and responsible. But all the work on the bill was completed before we left the House floor on March 13 as COVID-19 reached Vermont: before “stay at home”; before our businesses closed down and almost a quarter of Vermonters were left without jobs; before tax revenues plunged; before, in short, life as we knew it had completely changed.

The House Corrections and Institutions Committee had added an important clause to the bill. It noted the intent, and the importance of, investing these dollars as a part of rebuilding Vermont as we re-open. It went on to give authority to the Emergency Board, a group of Representatives and Senators who are chairs of the financial committees, to re-allocate any of the money from an approved project to a different capital project if a new COVID need emerges after the session adjourns next month.

I believed we needed to be more proactive as a legislative body. We are still very much in the dark about what the picture will look like in just a few months, enough so that for our operating budget, we are only planning to complete a first quarter bill in time for the new fiscal year that begins July 1. We will come back in late August to reassess and built the budget for the remaining three quarters.

I believed we needed that same process to occur for our capital budget – not to hold off on starting what is outlined in the bill, but to take stock of where we are and fully evaluate whether some priorities need to change, in August.

There is a difference between the bonding authorized in the capital bill for major expenditures, and the raising of taxes for the general fund. We can’t take some of that bonded money and shift it, for example, into buying food. But sometimes there is some wriggling that can be done to move some types of general fund expenses into the capital bill as longer-term investments, thereby giving some relief to the general fund.

As of right now, we are facing the need to cut every state program by eight percent or more. When you consider fixed costs and employee contracts, the impact could be massive, and could include major layoffs. There is also always the possibility that a necessary expense that we don’t even recognize right now will arise. If so, there could be a possibility of fitting it into a capital budget category.

We must take that deep look, in August, when we are building the rest of the budget and we know whether there are more federal support options and we know more about whether our re-opening of the economy is taking hold.

So, I introduced an amendment to require a report back from the administration in August that would identify all the impacts regarding the capital bill during these interim months, along with identifying any potential new needs that might be able to be shifted between budgets. In that way, we will have the opportunity, at the same time that we are building the general fund budget for the remaining three quarters of the year, to make changes that might help us get through this very difficult year ahead.

This, I told my colleagues, would enable me to stand behind the work done in the capital bill, and be able to assure my constituents that we are being appropriately cautious and responsible with the state’s resources in this crisis. I’m glad to say that when I presented the amendment to the Institutions Committee itself, the members worked with me to get the wording right, and then endorsed it. It was then accepted on the House floor.

It is a good capital bill. Even things like drapes in our historic statehouse do need to be maintained, and not left to crumble after years of damage by the sun. But we need to ensure that our capital investments do not in any way detract from our ability to respond to our more immediate crisis-level needs, and with my amendment, I believe we’ve done that. (And I received email notes of gratitude for the amendment from others on the House floor – the virtual floor – including Progressives, Democrats and Republicans alike. I think a lot of people were struggling with the idea of supporting a “business as usual” bill.)

***

Last week we worked our way through several additional bills that waived ordinary requirements in the law to ensure folks are protected from the coronavirus. One of them waived the requirement for a physical visit to a property by members of a Board of Civil authority when they are hearing an appeal of a property appraisal.

That one worried me. We need to be cautious that in our efforts at protection, that we don’t harm people’s rights. I proposed an amendment, and once again it was members of the committee themselves who recognized that the change was needed, and helped with framing it. It now allows a property owner to request that there be a “virtual inspection” by video or still photo which is initiated by the board and physically created by the owner. It’s not perfect, but it helps.

We have also begun to take up our first non-COVID response bills, to the extent time permits between essential bills. A bill to clarify tree warden responsibilities, one of those that had been sitting on the House calendar since March 13, passed after a fair amount of debate over whether it encroached too much on the local municipal process. It eventually did pass, and I voted no, but not because I thought it was bad to protect our town shade trees. It was simply because the member presenting the bill couldn’t answer my questions about the current statute, and how it works.

Chalk it up to the challenges of legislating by Zoom; I couldn’t feel comfortable voting for a change I couldn’t quite follow.

***

In my Health Care Committee, too, we have begun to take a small amount of time to try to finish a bill that was underway just before March 13. I’m particularly hoping that we can get a few key pieces through.

One is an effort to get insurers all on the same page to waive pre-authorization requirements in situations where they virtually always are approved, regardless. It’s a headache, and a big paperwork cost, for doctors to have to go through an approval process when approval will always be granted, and when among five different insurers there are five different sets of rules about when approval is required. We worked hard to get all the players on board with a process to jointly develop more streamlined approaches, so it would be a pity if we could not get this bill across the finish line.

Likewise with a part of the bill that requires some quality oversight components attached to the additional funding the state is giving to the Brattleboro Retreat to keep it afloat. We backed ourselves into a corner with the Retreat by creating greater and greater state dependence on one hospital to deliver so much of the inpatient psychiatric care in the state. Now they are too big to fail.

But the problems there are not just financial. In my regular job as the editor of Counterpoint, the state’s mental health newspaper, I see the firsthand accounts of patients who have suffered from poor quality of care there. The staff of my agency spend time there, and report about changes in policies that are demeaning and inappropriate, such as keeping bathrooms locked so that a patient must find a staff person to let them in.

So, one of the sections in our bill will require the Retreat to collaborate in clinical team meetings with the Department of Mental Health to foster quality improvements and improve patient experience of care.

***

The first proposal for what to do with a really significant portion of the state’s $1.25 billion federal CARES Act coronavirus funds came from the governor last week. It suggests using about a third of it immediately to help bail out some of our businesses. If they fail, we all fail, since the jobs, taxes and economic base go with them. The legislature will need to dive in rapidly to assess the plan and make decisions, because it won’t do any good to help a business if it has already gone under.

It hasn’t been defined yet, but we know another major portion of money will be needed to shore up our health care system. This crisis has really underscored one of the things wrong with our current financing for health care. It is paid for as though it was any other sort of business, by the sale of goods: you get your cut stitched up and the doctor gets paid. But health care isn’t a commodity like shoes where the merchant is trying to entice you with the latest style. You’re never going to buy stitches unless you need them, but when you need them, you want the best ones, available right away.

We didn’t use care in March, April and May because we were preparing for a major health catastrophe. That was the public health priority. The result was that no one was paying for the system continuing to be there for us. We are going to need to pay that bill now. But if we believe that the system needs to exist for when we need it, then it needs a more reliable mechanism for maintaining its infrastructure. That’s one of the components of health care reform that we need to keep chipping away at.

***

Please continue to stay in touch with me and with Rep. Ken Goslant. We’re both here to serve you, so contact us with questions or issues of concern. We were so glad to be able to intervene and help more than two dozen constituents from Berlin and Northfield who were jammed up in the unemployment system backlog. All but a few have finally been resolved. You can reach us anytime at adonahue@leg.state.vt.us or kgoslant@leg.state.vt.us